To Question of Estimation of Secretory and Proliferative Activity of GH-Secreting Adenoma

About the author:

Mykytyuk M.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scentific article

Annotation:

Aim. To estimate secretory and proliferative activity of isolated somatotropinoma (ST) and somato- mammotropinoma (SMT).
Materials and methods. We studied 133 patients (88 women and 45 man) (aged 44. 0 ± 12. 5 years old) with ac- romegaly (95 – with ST and 38 – with SMT). Term of disease was from 1 to 38 years. Disease activity was evaluated according to the Consensus Conference criteria (2000). To estimated age of patient, age of patient in manifestation of acromegaly (agemanifest.), duration of period before diagnosis (DPD) and duration of disease (DD). To elevated a
total secretory activity of adenoma (TSA) (ng/ml), secretory activity of unit of adenoma (SAUPA) (ng/ml/sm3) and
speed of tumor growth (STG) (sm3/years). The volume of hypophysis (VG) was calculated using the formula, which refers to G. Di Chiro and K. B. Nelson, 1962.
To data are given as X ± s and nonlinear regression model equations parameters.
The miсroadenomа in manifestation of acromegaly is verified only in 3,2 % patients, macroadenoma – in 92,2 %,
giant adenoma – in 4,9 %. In 0,74 % patients found empty sella turcica. In a general group the VG was associated, as with agemanifest. (r = -0,41; P = 0,006), so with GH (r = 0,37; P = 0,046). The group SMT VG more higher, than in a group ST (Me 5,21 and 2,42 sm3, accordingly) (P = 0,002) and associated with GH (r = 0,53; P = 0,03), but not with PRL.
The VG in a general group is associated with TSA (r = 0,38; P = 0,004), STG (r = 0,82; P < 0,00001) and SAUPA (r = -0,36; P = 0,006). The TSA in a general group is associated with STG (r = -0,36; P = 0,008) and SAUPA (r = 0,54; P < 0,0001). It is discovered association between STG and SAUPA (r = 0,56; P < 0,0001). It is set that in a group SMT SSA more higher, than in a group ST (Me 28,9[1,2-144,9] and Me 12,5[0,5-837,0] ng/ml, accordingly) (P = 0,02). The VG is associated with SSA both in a group ST (r = 0,54; P = 0,0006) and in a group SMT (r = 0,47; P = 0,04).
SAUPA in groups ST and SMT did not differ, however VG is associated with SAUPA in both groups ((r = -0,54; P = 0,0007) and (r = -0,75; P = 0,0002), accordingly). In a group SMT the VG is associated with PRL (r = 0,79; P < 0,00001), which determines 63,4 % his dispersion, in that time as a GH only 22,1 %. In a group SMT VG is as- sociated with SAUPA was calculated using the PRL (r = 0,8; P < 0,00001).
Correlation between STG and GH and STG and insulin-like growth factor-1 specifies on synchronousness of proliferative and secretory activity of growth hormone (GH)-secreting adenoma, and to reverse correlation between STG and SAUPA (rs = -0,41, P = 0,003) – connection is possible between the changes of receptor pattern of GH-
secreting adenoma and it proliferative activity.
Agemanifest. is modulated on secretory and proliferative activity of GH-secreting adenoma. The increase of VG in patients with acromegaly is accompanied the changes of specific specialization of GH-secreting adenoma, what leads prevailing of proliferative potential above secretory.
The presence of association between the clinical flow of acromegaly and secretory and proliferative activity of GH-secreting adenoma, in particular connection between «aggressive» clinical flow a SMT with their high secretory and proliferative activity. It is set that considerable duration of DPD and DD is inherent the of high «benign» clinical flow of acromegaly at in relation to low TSA, to «malignant» – insignificant DPD and DD at high TSA of GH-secreting pituitary adenoma.